vagotomy

A vagotomy is a surgical procedure involving the cutting or selective interruption of branches of the vagus nerve. The vagus nerve is the longest cranial nerve in the body, extending from the brainstem to the abdomen; it plays a crucial role in regulating numerous involuntary bodily functions, including digestion, heart rate, respiration, and even mood.

Historically, vagotomies were a main treatment for peptic ulcers, which are sores in the lining of the stomach or duodenum. The vagus nerve helps stimulate the secretion of gastric acid, so interrupting its signals can reduce acid production and help ulcers heal. Before modern acid-lowering medicines became widely available, this made the procedure an important part of ulcer surgery. Today, proton pump inhibitors (PPIs), antibiotics for H. pylori, and other treatments have greatly reduced the need for vagotomy, so it is now used far less often and usually only in limited surgical settings.

There are different types of vagotomies. A truncal vagotomy cuts the main trunk of the nerve, while a selective vagotomy cuts only certain branches in an effort to preserve more normal function. A highly selective form may target fibers that go mainly to the acid-producing part of the stomach. Because cutting the vagus nerve can also affect stomach movement and other digestive functions, the procedure may be combined with another operation to help the stomach empty properly. Possible side effects include diarrhea, delayed stomach emptying, or dumping syndrome, in which food moves too quickly from the stomach into the small intestine.

The name comes from vagus, from a Latin word meaning "wandering," and -tomy, a Greek-derived ending meaning "cutting." So the word literally refers to cutting the wandering nerve. In modern English, it is used mainly in medical contexts to describe this specific operation, most often when talking about ulcer surgery, surgical history, or the effects of reducing vagus nerve input to the stomach.